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Letters to the Editor
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National boards
Clarifying misconceptions
From Mr P. Jones, MRPharmS
The leading article in The Pharmaceutical Journal of 9 July (p34), drew
attention to the small amount of correspondence submitted regarding the
proposed new national boards. Could it be that members wishing to submit
a response have felt constrained by the amount of space offered by a
letter, and that their considered response to the consultation paper
has been sent to Michele Savage direct?
The letter you published from Stan
Wheatley (p45), however, deserves
a response because it perhaps identifies some of the misconceptions that
may exist.
The three national strategies referred to are similar, but not identical,
in the same way that bricks and mortar may all look similar, but the
buildings they ultimately comprise vary considerably in shape and design.
For example, the English “Pharmacy in the future” is essentially
a strategy for pharmacy, whereas Scotland’s “The right medicine” is
a strategy for pharmaceutical care, in which it is acknowledged that
pharmacists are key stakeholders in delivering pharmaceutical care, but
not the only stakeholders.
Since the establishment of the Scottish Parliament in 1999, Scotland’s
health, a devolved matter, accounting for approximately 40 per cent of
the total budget, has had a high political profile. It should be remembered,
however, that since the inception of the NHS in 1948 Scotland has always
had a separate NHS, with separate NHS Acts and Circulars. Furthermore,
when the Secretary of State for Health speaks in the House of Commons
his or her comments only refer to England and Wales: they do not apply
to Scotland.
It may be helpful at this stage to give a few examples of some of the
developments in Scotland since devolution and how this has differed from
what is happening in England:
Scotland has moved towards developing community pharmacy as an integral
and visible part of NHS primary care services.
Community pharmacies in Scotland are regarded as walk-in centres, providing
access to NHS primary health care services. It has not been necessary
to set up separate facilities.
The chairman of the Scottish Executive has been able to give oral evidence
to the Health Committee on the draft Smoking, Health and Social Care (Scotland)
Bill.
A professional view on supervised methadone has been submitted to the Petitions
Committee of the Scottish Parliament in response to a petition raised on this
subject.
A parliamentary briefing on the issues surrounding the proposals to change
or abolish prescription charges has been delivered in partnership with the
British Medical Association.
Ministers and MSPs are readily accessible and welcome approaches by health
care professionals on matters that have a bearing on delivering the health
care agenda in Scotland.
The Royal Pharmaceutical Society is a London-based organisation with an agenda
attuned to the Department of Health. The Scottish Executive Health Department
(SEHD) has a different health care agenda with different priorities, so can
a body in London really be the most effective organisation to formulate policy
which is not in tune with the agenda of the SEHD? Devolution provides an opportunity
to engage more closely with the audiences pharmacists need to address: it is
not necessary for everything to be done in London — indeed devolution
offers an opportunity to make more progress and to do so more rapidly through
being able to have more focused national perspectives.
Formation of three boards would have the advantage of the Council operating
at a strategic level and concentrating on the regulatory issues, whereas the
boards would be able to be the professional arm of the Society dealing with
the professional and practice aspects of the profession. Scotland has been
able to benefit already from developments under a devolved structure — is
there any reason why England should not similarly benefit? Without a separate
board for England, the Society’s Council would be in the difficult situation
of trying to offer English operational and strategic policy advice while at
the same time, providing British regulation and development of a GB-wide policy.
The question of cost of the new arrangements was also raised. It is quite likely
that there may be some small additional costs, and perhaps this is a fair price
to pay for an improved and more effective professional body. But has Mr Wheatley
considered that for many years Scotland and Wales may have been getting an
inequitable share of resources from a body that is ostensibly a GB organisation.
Equitable distribution of resources and some element of decentralisation would
be in line with the policies of many other London-based organisations, and
would also facilitate the sharing of good practice between the three countries.
In conclusion, I strongly support the development of three separate boards
for England Scotland and Wales and believe this to be the correct way forward
for the Society to be an effective regulatory and professional organisation
within a politically devolved UK. At the same time, let us also be aware of
what has happened in New Zealand where the pharmaceutical society has been
disbanded and replaced by a government regulatory body. At a time where there
are so many opportunities for significant advancement of the profession of
pharmacy, a united, positive and proactive approach is vital.
Peter Jones
Edinburgh
Will new national boards mean an increase in retention fees?
From Mr M. A. Walker, MRPharmS
“Divided, we
stand” (PJ, 12 February, p164) and “A
wake-up call” (PJ, 4 June, p666) have been two attempts by the PJ to ignite
the devolution debate within the Royal Pharmaceutical Society, yet there
is scarcely a trickle of letters on the subject of devolution.
Colin Ranshaw (PJ, 2 July, p31) extols the need for a Welsh board but fails
to make any connection with the cost of such a board. If the 2,200 pharmacists
who reside in Wales say “we want, need and will pay for a Welsh board”,
I would certainly wish them well in their endeavours. However, a Welsh
board with a small budget of say £200,000 would cost each Welsh pharmacist
nearly £100. Would anyone hear singing in the valleys if this was
the size of increase in the Welsh retention fee?
Our elected members of Council must ask some pointed questions and publish
the answers before they ask the members accept any devolution proposals.
As a minimum I expect to know:
· How many jobs will move from Lambeth to Cardiff and Edinburgh
· How many new jobs will be needed in Cardiff and Edinburgh
· What the reduction in running costs of GB representation will be
· What the annual running costs of English, Scottish and Welsh boards will
be
· What the transition costs for devolution are
· What the increase in retention fees for pharmacists resident in England,
Scotland or Wales will be
Devolution is being proposed as “good idea”. Unless the Devolution
Review Group produces a full costing of its proposal and says who will
pay for the change, then members should expect a significant increase in
the retention fee to pay for the extra costs. It could be that members
in Scotland and Wales will face a hike in their retention fees. Or maybe
Lambeth thought that pharmacists in England would just pay for better representation
in Scotland and Wales, without batting an eyelid.
I support better representation by the Society. If pharmacists in Scotland
and Wales want and will pay for their own boards, then we pharmacists in
England will need our representative board. However we all need to know
by how much our retention fees will increase, if we want devolution. Then
we need to vote on the matter, as it is a major constitutional change for
the Society.
Mark Walker
Oxford |
The
Pharmaceutical Journal